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BENEFITS

Medical Insurance

Anthem | Value Deductible HMO

With the Anthem Health Maintenance Organization (HMO) plan, you must choose a primary care physician (PCP) or medical group
within the network. All of your care must be directed through your PCP or medical group. Any specialty care you need will be
coordinated through your PCP and will generally require a referral or authorization. You will receive benefits only if you use the
doctors, clinics and hospitals that belong to the medical group in which you are enrolled, except in the case of an emergency.

Anthem | PPO
This plan is a “qualified” High Deductible Health Plan (HDHP) through Anthem, which combines a high deductible plan with
a special, tax-qualified savings account called a Health Savings Account (HSA). You have the freedom to choose your doctor
without using a Primary Care Physician (PCP) and you may self-refer to specialists. You may use a network provider whose
negotiated rates provide richer levels of benefits with claim forms filed by the providers. You may also obtain services
using a non-network provider; however, you will be responsible for the difference between the covered amount and the
actual charges and you may be responsible for filing claims. This plan requires all medical and prescription drug expenses to
be applied towards the deductible before services are covered, except for preventive services. Additional information on
how the HDHP plan works is located on page 7.

Finding a Medical Provider
Go to www.anthem.com/ca or call (800) 888-8288. HMO participants should refer to the “Blue Cross HMO
(CACare)” network under Large Group, and PPO participants should refer to the “Blue Cross Prudent Buyer
(PPO)” network under large group, when prompted. For providers outside of California, select “National PPO
(BlueCard)” network

Virtual Visits: Go to www.livehealthonline.com

Plan Differences HMO HDHP

Out-of-Pocket Costs $ $$

Savings Account ✓
Cost Sharing Contribution, Copay, Coinsurance Contribution, Copay, Deductible, Coinsurance

Network
- Name Blue Cross HMO (CACare) Blue Cross Prudent Buyer (PPO)
National PPO (BlueCard) outside of California
- Size  
- In-Network Benefits ✓ ✓
- Non-Network Benefits ✓

Access to Providers Managed by Your PCP Managed by You
- Primary Care Physician Required Not Required
- Referral for Specialist Required Not Required

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